HR Management & Compliance

New HIPAA Regulations Welcome Wellness Programs

Under HIPAA, it’s been very difficult to run a company wellness program – until now.

If there has been one constant theme in government employment regulations, it’s the battle against discrimination. Anything that even hints at bias is absolutely prohibited, even to the point, some feel, of being counterproductive.

Such has been the case with wellness programs.

If a company wanted to hold a daily 30-minute walkathon during lunch, and one worker was in a wheelchair and couldn’t take part, under current law … and particularly the Health Insurance Portability and Accountability Act (HIPAA) …  the whole deal was off. No scheme that treated anyone differently, no matter how beneficial for the majority of employees, was allowed.

Until now, that is.

In December, the U.S. Department of Labor issued new regulations to clarify how wellness programs could be implemented in a way that was, in their opinion, non-discriminatory. Essentially, you can run a wellness program if you meet these conditions:

–Design a program in a way that “reasonably promotes health or prevents disease.”

–Build in ways that all employees can participate, say, in the above example by having the wheelchair-bound worker roll along with the walkers, or in the case of a temporary disability, like a leg injury, by offering a short-term waiver without loss of credit toward the reward.

–Offer all employees the chance to qualify for a reward at least once a year.

–Limit reward size to a reimbursement or waiver of a health-related cost such as a medical co-pay or cost of a preventive medical test or program, or even a cash award. No matter what its form, the reward cannot exceed 20 percent of the cost of the employee’s annual healthcare premium.

–Include the fact that alternative forms of participation or waivers are available in all communications about the plan.

Plans That Fit

DOL also provided some examples of wellness plans that would fit its parameters:

–A program reimbursing part or all of the cost of membership in a fitness center.

–A diagnostic testing program or health remediation plan that do not base reimbursement on the outcome. One example is a stop smoking program that the company pays for, whether or not the smoker quits.

–A program that rewards workers for attending a monthly health education seminar.

The new rules take effect the first day of your next plan year after July 1, 2007. For most plans based on a calendar year, the effective date will be January 1, 2008.

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